Comprehensive treatment –Full Mouth Rehabilitation case

By: Aisha Abdulla

Roll No: 1001

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This work was achieved by the student: Aisha Abdullha under the supervision of dental teaching staff at Libyan International Medical University:

Dr: Rafik M AlKowafi Dr: Abdelmonem Abdelnabi. Dr:Ali Bosnina . Dr: Amal Alawamy . Dr:AbdelsalamElhdad Dr:Nuha Elkadik . Dr:Kadiga Elfallah.

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Personal Data

Name : A.S.B.

Age : 49 years (30/05/1970).

Gender: Female.

Nationally : Egyptian.

Occupation : House wife.

Address : Alwhashy / Benghazi

Material & Society : Married.

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Chief complaint & History of Chief complaint

Chief complaint :

“ I am not satisfied with my current smile” .

History of Chief complaint :

Bad smile due to poor restoration that carried out 5

years ago, also she note discolored upper anterior

tooth and the other is fractured and she dose not

remember the Couse, patient is not satisfied of her

smile in term of discolored restoration, color of teeth

and last is the fractured tooth.

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Medical and Drug History:

Medical history : diabetic patient since 2 years on metformin 500mg/day and last reading for HBA1c =11( NON CONTROLLED CASE) , F.B.G.=227mg/dl

Drug history : METFORMIN

Allergic history :N.O.S

Family history : N.O.S

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O.H.P. : brushing her tooth once /daily ,soft tooth brush

,no specific tooth paste .

Any other interdental cleaning aids: No

Attitude towards dentistry: Fair

Type of dental treatment:

o Previous restorative.

o Endodontic .

o Extractions without complication .

o Prosthodontics .

- Reasons for loss of teeth if any: caries

Dental history

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Extra-oral examinations

Symmetrical face

Ovoid form

Competence lip , lower lip line .

No Swelling .

No scaring .

TMJ status : Normal with Average Mouth opening

Lymph nodes :Not palpable

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Intraoral examination:

Soft Tissue :

Halitosis: Present.

Gingiva:

Gingival recession.

Gingival enlargement.

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D.I=6/6 =1 C.I =2/6=0.3

OHI STATUS: 1.3 FAIR

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Gingiva and periodontal Status

Pink.

Round gingival margin , blunt IDP.

Bleeding on probing .

Localized gingival recession .

Pocket depth 1-4.

CAL 0-3MM.

No exudate , No Mobility ,No swelling

Normal frenal attachment .

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Diagnostic Cast Analysis .

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DMFT :14 12

Frontal view

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Lateral View

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Radiographic Examination

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Panoramic view show Maxillary & Mandibular Generalized Mild

periodontitis .

Endodontic treated upper Rt lateral , Upper Lt Canine & Lower Rt 2nd

Premolar .

Show Large Lesion related to Upper Rt Canine .

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IOPA X-ray

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Investigation

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Final Diagnosis :

Generalized mild chronic periodontitis.

Multiple Caries . 7 8

7 43 1 2 3 4 5 6 7

Recurrent caries 7

Radicular Cyst related to Upper Rt Canine .

Endodontic treated with badly destructive Crown.5

Edentulous areas “Kennedy classification “

o Upper arch : Class III .

o Lower arch : Class II.

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Phase I : O.H instruction & scaling

phase II: Surgery (cyst enculcation with curettage ) & apicectomy 3 .

Phase III : RCT 5 3 1

Retreatment 5 2 3

restoration : 7

Composite restoration 4 3 1 2 3 4 5 6 7

Amalgam restoration 7 8

Composite Veneer 2 3

Replacement :

Custom made poste & core + PFM Crown 5

Custom made poste & core + E-Max 5 2

Replacement by E-Max Crown 1 1 4

Replacement RPD .

Treatment plan

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Patient Informed Consent :

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Phase I therapy :

Patient motivation.

Oral hygiene instructions.

Scaling.

Diet Sheet .

Re-evaluation .

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Diet sheet

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Scaling

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Before after

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Re – evaluation

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Phase III RCT : upper Right canine

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Root Canal Treatment upper left central

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Retreatment upper right lateral

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Retreatment lower right 2nd premolar

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Retreatment upper left canine

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Root Canal treatment upper 1st premolar left

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RCT : Upper right 2nd premolar .

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Redo

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Patient Informed Consent :

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Surgical Procedure

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Biopsy

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Histopathology Report

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Phase III : Filing restoration lower Lt posterior 1st molar & 2nd molar . Class I

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lower Lt posterior 2nd premolar Class I

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Upper Rt 2nd Molar Class II

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Lower Rt 1st premolar Class II

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Upper Lt 3rd Molar Amalgam Class II

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Lower Rt 2nd Molar Class II

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Lower Rt Canine Class VI

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Lower Rt Canine & 2nd premolar Class V.

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Lower Lt Canine Class V & IV

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Lower Rt Central Class V

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Composite Veneer

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Custom Made Post , Core And E -Max crown .

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Temporary Post and Crown

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Post Placement and Cementation

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Composite build up

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Post and core

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Final Impression

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Try in

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Insertion

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Custom Made Post ,Core And PFM Crown .

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Post Placement and Cementation

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Tooth preparation and Final impression

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Temporary Crown

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Metal Try In

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Insertion

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Post Space Preparation & Placement

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Composite build up

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Post Placement and Cementation

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Tooth preparation and Final impression

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Insertion

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Primary impression

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Try in

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Insertion

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Primary impression

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Try In

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Before After

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Before After

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Before After

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